Predictors of airway intervention in acute supraglottitis (AS), a recent 7- year experience

Author(s):  
Prince Vaid ◽  
Eric Farrell ◽  
Martin Donnelly
Keyword(s):  
1995 ◽  
Vol 109 (12) ◽  
pp. 1197-1199 ◽  
Author(s):  
R. B. S. Laing ◽  
P. J. C. Wardrop ◽  
P. D. Welsby ◽  
R. P. Brettle

AbstractThe immunodeficiency which results from HIV infection is associated with a range of opportunistic infections and tumours which may present with the symptoms of upper airways disease. This paper presents three cases of stridor from different causes in patients with HIV infection, all of whom recovered following treatment. The management of this problem requires consideration of the likely aetiology which, in those with advanced immunodeficiency, includes bacterial and fungal laryngitis and epiglottitis as well as rapidly growing laryngeal tumours. Recommendations for the treatment of those with HIV infection who present with severe or rapidonset stridor should include a combination of aggressive airway intervention and broad-spectrum antibacterial and antifungal agents. Laryngeal biopsy for histology and culture is particularly important for those patients who fail to respond to the aforementioned treatment.


2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 10-18
Author(s):  
Ian L Hudson ◽  
Megan B Blackburn ◽  
Amanda M Staudt ◽  
Kathy L Ryan ◽  
Elizabeth A Mann-Salinas

Abstract Introduction Airway compromise is the second leading cause of potentially survivable death on the battlefield. The purpose of this study was to better understand wartime prehospital airway patients. Materials and Methods The Role 2 Database (R2D) was retrospectively reviewed for adult patients injured in Afghanistan between February 2008 and September 2014. Of primary interest were prehospital airway interventions and mortality. Prehospital combat mortality index (CMI-PH), hemodynamic interventions, injury mechanism, and demographic data were also included in various statistical analyses. Results A total of 12,780 trauma patients were recorded in the R2D of whom 890 (7.0%) received prehospital airway intervention. Airway intervention was more common in patients who ultimately died (25.3% vs. 5.6%); however, no statistical association was found in a multivariable logistic regression model (OR 1.28, 95% CI 0.98–1.68). Compared with U.S. military personnel, other military patients were more likely to receive airway intervention after adjusting for CMI-PH (OR 1.33, 95% CI 1.07–1.64). Conclusions In the R2D, airway intervention was associated with increased odds of mortality, although this was not statistically significant. Other patients had higher odds of undergoing an airway intervention than U.S. military. Awareness of these findings will facilitate training and equipment for future management of prehospital/prolonged field care airway interventions.


2020 ◽  
Vol 45 (3) ◽  
pp. 334-341
Author(s):  
Steven Powell ◽  
Kim Keltie ◽  
Julie Burn ◽  
Helen Cole ◽  
Adam Donne ◽  
...  

2019 ◽  
Vol 57 (3) ◽  
pp. 314-321 ◽  
Author(s):  
Gabrielle Hester ◽  
Timothy Barnes ◽  
Jodi O'Neill ◽  
Gloria Swanson ◽  
Tracey McGuinn ◽  
...  

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P62-P62
Author(s):  
Jason L Acevedo ◽  
Lina Lander ◽  
Sukgi S Choi ◽  
Rahul K Shah

Objective To describe demographics and utilization in the treatment of epiglottitis. Methods The Kids’ Inpatient Database (KID) was used to extract data for patients 7 years old and younger with a diagnosis of epiglottitis; children undergoing airway intervention (intubation or tracheostomy) were studied. Results 33 patients were identified that were either intubated (n=31) or had a tracheotomy (n=3); 1 patient that had a tracheotomy was intubated prior. The mean age of patients was 1.7 years old; 58% being 2 years older or less. 52% were male, and 42% were Caucasian. Average length of stay was 17.7 days (range=0–199). January and October were the most common months for admission (n=5, each). Of admissions - Texas and Massachusetts handled the most (n=4, each). Average total charges were $83860. Private insurance was the primary payor in 55% of cases; 18% patients were discharged to shortterm care facilities. 73% of cases were managed at teaching hospitals; all tracheotomies were at teaching hospitals. There were no mortalities. Conclusions In the post-HiB era, epiglottitis has become a rare entity. Of children under 7 years of age, only 33 required airway intervention in the 36 states sampled in 2003. More than half of affected children were, on average, 2 years old and younger. Airway intervention for epiglottitis is associated with high total charges and prolonged hospitalization. Epiglottitis is a rare, expensive, and protracted disease to treat in the HiB vaccine era. The infrequency of this disease has significant implications for resident education and training.


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